Korean J Radiol.  2004 Jun;5(2):87-95. 10.3348/kjr.2004.5.2.87.

Functional Neuroanatomy in Depressed Patients with Sexual Dysfunction: Blood Oxygenation Level Dependent Functional MR Imaging

• Yang JC

• KMID: 753987
• DOI: http://doi.org/10.3348/kjr.2004.5.2.87

Abstract

OBJECTIVE
To demonstrate the functional neuroanatomy associated with sexual arousal visually evoked in depressed males who have underlying sexual dysfunction using Blood Oxygenation Level Dependent-based fMRI. MATERIALS AND METHODS: Ten healthy volunteers (age range 21-55: mean 32.5 years), and 10 depressed subjects (age range 23-51: mean 34.4 years, mean Beck Depression Inventory score of 39.6+/-5.9, mean Hamilton Rating Scale Depression (HAMD) -17 score of 33.5+/-6.0) with sexual arousal dysfunction viewed erotic and neutral video films during functional magnetic resonance imaging (fMRI) with 1.5 T MR scanner (GE Signa Horizon). The fMRI data were obtained from 7 oblique planes using gradient-echo EPI (flip angle/TR/TE= 90 degrees/6000 ms/50 ms). The visual stimulation paradigm began with 60 sec of black screen, 150 sec of neutral stimulation with a documentary video film, 30 sec of black screen, 150 sec of sexual stimulation with an erotic video film followed by 30 sec of black screen. The brain activation maps and their quantification were analyzed by SPM99 program. RESULTS: There was a significant difference of brain activation between two groups during visual sexual stimulation. In depressed subjects, the level of activation during the visually evoked sexual arousal was significantly less than that of healthy volunteers, especially in the cerebrocortical areas of the hypothalamus, thalamus, caudate nucleus, and inferior and superior temporal gyri. On the other hand, the cerebral activation patterns during the neutral condition in both groups showed no significant differences (p < 0.01). CONCLUSION: This study is the first demonstration of the functional neuroanatomy of the brain associated with sexual dysfunction in depressed patients using fMRI. In order to validate our physiological neuroscience results, further studies that would include patients with other disorders and sexual dysfunction, and depressed patients without sexual dysfunction and their treatment response are needed.

Keyword

Brain, MR; Brain, function; Magnetic resonance (MR) ; Functional magnetic resonance imaging (fMRI) ; Psychiatric disorders

MeSH Terms

Adult
*Brain Mapping
Cerebrovascular Circulation
Depressive Disorder/complications/*physiopathology
*Erotica
Human
*Magnetic Resonance Imaging
Male
Middle Aged
Oxygen/blood
*Photic Stimulation
Sexual Dysfunctions, Psychological/*physiopathology
Support, Non-U.S. Gov't

Figure

• 

  Fig. 1 Comparison of the brain activation patterns between a healthy volunteer (42 years old) (A) and a depressed subject (40 years old) (B) in neutral condition. The colored functional maps were overlaid on the T1-weighted MR images. Note that the level of activation is significantly stronger in a healthy volunteer than in a depressed patient, especially in the visual and cerebellar cortices.

• 

  Fig. 2 Blood oxygenation level dependent-MR images on the 19 contiguous axial slices associated with visual sexual stimulation in a 42-year-old healthy volunteer. Color-coded pixels on the activation maps were scaled to the range between the cutoff-threshold (p < 0.05) and the highest t-score, 8.96. Prominent activation areas involve the occipital, temporal, cerebellar gyri, and the limbic systems associated with the regulation of sexual behaviors.

• 

  Fig. 3 Blood oxygenation level dependent-MR images on the 19 contiguous axial slices associated with visual sexual stimulation in a 40-year-old patient with depression. Color-coded pixels on the activation maps were scaled to the range between the cutoff-threshold (p < 0.05) and the highest t-score, 7.67. Activation is limited in the frontal and occipital cortices; any other limbic areas except part of the cingulate gyrus were not apparently activated in this case.

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